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Originally Posted by Pawtucket
Docicu3, when you have a moment, can you venture a guess as to whether the following excerpt from Saturday's DRF piece on Andrew Lakeman's treatment contained a typo?
At http://www.drf.com/news/article/85269.html, the article said in part:
Two quarts in two minutes? Could they have meant two pints in two minutes?
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Packed cells actually come in units which are intended to raise a hemoglobin by 1 gram/DL or hematocrit by 3%. The volume of a bag varies by the amount of plasma in it, or volume of material other than red cells. The bag holds 390 mls.
The usual way this is done is when a patient in hypovolemic shock from
hemorhage comes into a trauma unit time is of the essence so they infuse "O"
negative blood which is a match for any blood type. These units are placed in a "rapid infuser" which infuse a "unit" of packed cells in less than a minute.
To answer the question though the medical people probably used the lingo we are used to in critical care and said they give Lakeman 2 units of blood in 2 minutes. It makes it sound unique if they don't tell you about the equipment which has become a common device in ED's and Trauma bays.
For the anal among us a unit = 0.1 gallon = 0.4 quarts = 0.8 pints.
Of note is the current controversy with using "polyheme" in situations like Lakeman's where a trauma patient needs rapid transfusion and there is only so much "O" negative blood in the world as the other types A, B, AB and +Rh units make up the majority of transfusions.
The front page of the Washington Post yesterday layed out the ethical argument in reference to "Is it ethical to do studies of resuscitation without true informed consent?" The gravely ill hardly are candidates for long consent procedures however the individual's rights must be preserved if at all possible. A number of trials are underway in university hospitals across the country trying to improve outcome in situations like Lakeman's using artificial volume expanders like "polyheme" a dextran type substance used to simulate blood to reverse shock before damage is done to organs of the body.
Other studies are about the resuscitations themselves with such projects as
1) hypothermia in cardiac arrest (if I cool a body to 32C within a short time of a heart stopping more people live with less impairment neurologically than if I don't) 2) shock vs CPR for first therapies in arrest situations etc. I am simplifying this greatly but since people seem interested I thought I would oblige.....I'm sure I put you all to sleep....lol.
DD